NPIMap

Organization Active NPI

Prime Medical Group

  • Internal Medicine Physician
  • Pittsburgh, PA
National Provider Identifier
1083856165
Registry record updated Apr 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD037112E Issued in PA
Legal business name
PRIME MEDICAL GROUP
Practice address
180 Fort Couch Rd
Suite 275
Pittsburgh, PA 15241-1041
Phone
(412) 831-2288
Fax
(412) 831-2679
NPI assigned
Apr 3, 2009
Last updated
Apr 3, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Darla Sethman
Title
Practice Administrator
Phone
(724) 929-2640

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD037195E PA
Internal Medicine Physician 207R00000X MD037112E PA Primary

Addresses

Primary practice location

180 Fort Couch Rd
Suite 275
Pittsburgh, PA 15241-1041

Mailing address

515 Broad Ave
Belle Vernon, PA 15012-1405
Phone (724) 929-4930

Other identifiers 3

IdentifierTypeStateIssuer
0010652420006MedicaidPA
0014701550001MedicaidPA
PENDINGOtherPAHIGHMARK BLUE SHIELD

National Provider Directory

National Provider Directory
Tax ID family
Prime Medical Group6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1238716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238716800000",
    "number": "1083856165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 BROAD AVE",
            "city": "BELLE VERNON",
            "state": "PA",
            "postal_code": "150121405",
            "telephone_number": "724-929-4930",
            "fax_number": "724-929-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 FORT COUCH RD",
            "address_2": "SUITE 275",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152411041",
            "telephone_number": "412-831-2288",
            "fax_number": "412-831-2679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-03",
        "last_updated": "2009-04-03",
        "status": "A",
        "authorized_official_last_name": "SETHMAN",
        "authorized_official_first_name": "DARLA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "724-929-2640"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD037195E",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD037112E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010652420006",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0014701550001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "PENDING",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.